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Tuesday, April 12, 2011

Nurses and Female Doctors

That is, nurses and female doctors who work together? Can they be good friends? Outside of the hospital setting?

I think the answer may be no. I wish it were yes. But I'm pretty sure it's no.

Where I work, most of the doctors are older. The nurses are younger, closer to my age, a lot are in the same stage of life in terms of having kids, etc. And there are many that I really like and I sense that they like me. We chat in a friendly way and have a sociable relationship. But I feel like there's this WALL between us that will keep us from ever being real friends. My tip-off is that they all call me Dr. Fizzy, despite the fact that I have asked several to call me by my first name. The only ones who call me by my first name are.... the MALE nurses.

Of course, for male doctors, I think it's a different ball game. Because they can flirt. I don't know how many male doctors have become friends with the nurses they worked with, but I bet there are plenty that have started dating.

34 comments:

I was once really good friends with a nurse. I'll never forget her telling me one day "You really love writing those words "Pitocin as ordered" don't you? You know that my life for the next umpteen hours is going to be hell and I'm going to be working my a-- off". I was so shocked. To me, it was about getting the baby delivered, and we were a team in making that happen. To her it was about me bossing her around.

I still think docs can be friends with nurses. I call several nurse practitioners my friends. My sisters are nurses after all. But that one day made me realize how steep the wall is one needs to climb to make that happen.

But we do have to pay attention to language. In a team is 'ordered' the best word to use? OK, doctors order tests from other doctors but do do nurses ever 'order' doctors? Would they ever write that a doctor was ordered to examine a patient in notes, for example? Would a nurse 'order' another nurse to do a task? We can become so familiar with the language we use that we don't realise the meaning it has for others. Working in teams has to involve developing these kinds of understanding.

With regards to the original post I can't see any reason why doctors and nurses can be friends. I am friends with the nurses who I work with in primary care.

@Fizzy I guess I didn't understand from your post what the nature of the 'wall' was. Why can it be overcome by male-female friendships? It sounds as if gender is a very powerful force in this as you describe it.

Anne Marie: Saying you socialize as much with the doctors as you do with the nurses doesn't mean much if you don't socialize with the doctors. Do you socialize outside of work one on one with nurses?

I'm not sure if male doctors and female nurses can have a real friendship either, but they can have a different kind of relationship. It may be controversial to say this, but I think it's partially b/c women don't mind as much getting "orders" from men as they do from women.

As a nurse, I think it gets uncomfortable to be friends with a doc, just like it would be uncomfortable to be social friends with one's boss in any field. Because a very real degree, docs are the "bosses" of the nurses. Any employee would be careful of what they say around their bosses, because you can never unsay something that makes your boss mistrust you at work. It's hard to be a real friend to someone when you have to watch what you say.

@Fizzy Basically, I'm trying to say that I have worked with these people for 9 years and I consider them friends. I don't go to the movies with anyone that I work with, but we have participated in sports events together (with admin staff as well), and socialised around these. We call each other by first names. I show them family photos. I tell them about problems I might be having.

I've pointed out that primary care might be different, especially as I'm not the employer of these nurses.

I think this is a worthwhile topic to discuss, especially for a blog of female doctors.

I'm going to have to agree with Fizzy on this one, although I'm not sure about male vs. female.

I tried to be friends with my nurses when I was in my first job. It worked well for a while (i.e. social events outside of work) until one nurse had some performance issues and it became awkward trying to figure out if she needed to be written up for it, etc.

I think it's a totally different ball game with NPs and PAs since they are also providers, but it is a little awkward if you are their supervising physician.

I'm not sure if the relationship is more difficult with women doctors and women nurses versus man doctors and women nurses. The man physicians I've worked with in the past and present are not friends with their woman nurses at all.

I think it's easier to keep things separate from a professional standpoint. Currently I am friendly with the nurses and staff - we talk about our lives, families, we have office-related social events, but we don't do anything outside of work together, we aren't friends on facebook, and I like it better this way, because it allows me to be more objective at work when I need to.

I think whether female docs and nurses can be real friends depends a lot on the practice environment. I spent 4 years in the military as a physician and was the same rank as many of the nurses. That dissipated some of the usual nurse/doctor hierarchy issues and I made a very good nurse friend, who remains a friend today. We live in different states now but if the opportunity was there, would go to the movies together, get our kids together, etc.

The hierarchy is much more rigid at my current civilian hospital so it would be MUCH harder to overcome it, though one of my former partners did- she had a true bosom friend among the nurses.

I think women have a harder time forming friendships when there's a large power differential, whether real or perceived.

I have good friends that are nurses but we don't work together. So, I don't think it is realistic to be friends with nurses at my hospital/office. It may be that the type of work environment makes a difference. I am in a small town rural hospital and like Kelly above, I initially was friends with a few of them and it became very akward when there were performance issues. Actually, not just akward but big blow up kind of stuff - blah!

So, I learned the hard way that it is definitely not possible for me here to be close friends with nurses. I can be friendly yes, but not close. I look at my close friends here (few and far between for reasons discussed many times on this blog!!) and they are all professionals in the area - one is my PA, a pharmacist, lawyer and a principal. These are women whom I can trust and who understand the nuances of being a mom and a professional.

RNmom: I understand that, as I've had attendings who wanted to be friends and there was always kind of an awkwardness we couldn't overcome because they were essentially my boss, even if they weren't my direct attending.

Kelly: I don't know any male physicians who are friends with female nurses they work with. But I know a lot who have dated them!

smalltowndoc: I do think it's possible to be friends with a nurse you don't work with. But people do naturally make friends with the people they work with (sometimes) so it's sad that it can't happen between doctors and nurses.

I think the real question is: why do you want to be their friend? You work with these people. Sure, sometimes friendships come from work, but more often they don't. There's nothing wrong with having a friendly but professional relationship. Perhaps, under the right circumstances, these relationships could potentially grow into a real friendship. But if you're wondering why is just isn't happening between you and the nurses, perhaps you're just expecting too much.

I don't really think this is a woman thing either. A flirtation is not the same thing as a real friendship. The male drs aren't really "friends" with the female nurses either.

OMDG: Well, in college, my friends were my classmates; in med school, my best friends were other students; in residency, etc etc. So I guess I expect to make friends in the same place I work. Plus I've moved around so much in the last several years that I have to keep starting from scratch, so I'm looking for the path of least resistance. But you're right that it's probably not a good idea anymore. And I'm not *wondering* so much as just kind of irked by it.

Well Fizzy, now that you have your first real job, welcome to the reality that your coworkers won't necessarily be your friends. Working (unfortunately) is nothing like being a student. One of the sucky things about being an adult is that it's harder to make friends than it was in school -- or at least friendships of the same intensity. Sometimes you get lucky and it happens, but lots of times it just doesn't. One of the nice things about medicine as opposed to other fields is there seems to be more camaraderie between people who work together, but you should realize that's not the norm for a lot of / most workplaces.

When I was a surgery resident in the 1980s I was friendly with the nurses, but there was always a slight discomfort in the relationship. The RNs generally were comfortable being friendly with doctors and with women-- but in different ways, and it was hard to combine it. But generally we figured out a friendly relationship that worked.

I am friendly with the RNs I work with, although few of them are truly my friends. But I count many RNs among my closest friends. Some of these friendships began as working relationships and were sustained when we stopped working together. Most are through my professional society, which includes MDs, RNs, PhDs, PTs, DPMs and many others.

In general I agree with the concept of maintaining a friendly professional relationship with co-workers, especially if I have the power to give them orders.

One of my closest friends in the world is a nurse who I met (and worked with) for three years while a resident. So yes, I think its possible. we don't work together anymore, but I've counted her among my clsest friends since internship.

I agree with the above poster who said its harder to make real friends at work after fellowship/residency/med student days. I've been in the same division for 10 years now, and while I really like and enjoy many of my physician colleagues, we have a different relationship I did with my co-residents/fellows and I wouldn't call us "friends" in the same way. I've made very good friends though with people in other divisions where we socilalize outside of work. I don't work directly with nurses very much anymore - I think if you were their direct supervisor it wouldn't be advisable to be "friends". I'm not "friends" with my boss(es) either - but i really like them and have a good working relationship.

I am a former nurse, now doctor. I think down here (Australia) the heirarchy in hospitals, while very much still there, is changing a lot. I absolutely have close friends who are nurses. We socialise, our kids socialise, they are some of the most important relationships in my life.

We respect each others professional roles,I find nurses invaluable resources on things like wound dressings and hospital logistics. My child health nurse friend shares her techniques for low trauma vaccinations which I very much appreciate. My nurse friends respect my role and will often ask my advice. Where possible I talk through why I;ve decided to do something a certain way (if the nurse is initially unhappy).

When I was going through Nursing school I worked as a patient care assistant. While I was going through medical school I worked as a nurse. Each and every person in the working environment has a key role to play.

My first job as a doctor I became very close to the receptionists who welcomed me socially to the town and invited me to join their sports teams etc.

This is not an unusual phenomena in Australia and I imagine a similar blog post would get very different responses. I wonder if it is due to different workplaces? Different culture in the wider society? Not sure.

I wonder if it is a little bit different in pathology? One of our senior level pathologists used to be a med tech and she has some very close friendships with the med techs that she started a flow cytometry lab with years ago.

I have also developed a good friendship with a PA in the gross room - she is about my age and yes, we go to movies together. Reading all of the above makes me wonder if this was, in retrospect, a bad idea, but I think overall we do a good job of keeping our friendship off of the political aspects of work - purely social and mostly our outside of work interests. Here's to hoping I can be Australian and continue my close friendship without troubles.

smalltowndoc - I was in a very rural setting in my 1st job, and am in a semi-rural setting my 2nd job.

Old MD Girl - I absolutely agree about the difference in making friends as a student/resident vs. in private practice. Most of my closest friends were my peers, but in my first job the other doctors were older men, and a close friendship just didn't happen. In this job there is one other older doctor who's a man, and I don't even see him because he's in clinic when I'm not, so obviously that's not happening either. I miss having a large group of similar aged and similarly minded women professionals to befriend, but that's just the nature of my job. I'm sure it's different for those who work in larger groups with more women.

I also do not think male doctors dating female nurses counts as friendship. I think it's even more difficult for these demographics to become friends, and there aren't many male nurses to have male doctor-nurse friendships. So just from the standpoint of demographics it becomes a female doctor-nurse friendship issue.

I'm friends with the paralegals I supervise- actually have a good number of friends among them, and it's a similar dynamic. I suspect it has more to do with the individual workplace than with the dynamic. Some workplaces are more hierarchical than others.

I also know that my OB is BFF's with a specialist nurse she works with from time to time- not constant supervision but they do interact professionally.

I'm friends with nurses in the ER: Facebook, parties, occasional clubbing, the full meal deal, but I think ER people are less impressed by hierarchy and so are younger people.However, I've recently realized that envy/jealousy is an unspoken problem in some of my other friendships (getting a lot of "You have it all" kind of comments and some passive aggressive crap) and I'd love to see MiM address this. Thanks!

Quite late, but I wanted to say thanks for this post! I'm an M2, and this is actually a topic that's brought up quite a bit as we ask upperclassmen for advice about starting our clinical years. The consensus does seem to be that female med students (and residents) have a more difficult relationship with nurses than the males do.

I do sometimes wonder whether some part of this has to do with constant patient assumptions that the females on the care team are nurses -- constantly hearing "no, I'm a med student/doctor" would bother me if I were a nurse. This is such a tricky topic and I do hope conversations about it continue!!

I think it's interesting that you note that because the nurses call you Dr. X rather than your first name, that you can't be friends. I've heard almost opposite concerns from female physicians at my institution (where i'm an M2)- that the nurses will call the male doctors Dr X but then be more casual, first name basis with the female doctors. That particular doctor noted that while she liked being friendly with the nurses, they were less likely to think of her as a boss. (the example she gave her was that for the male doctors it would be "here's the chart, dr. x" where as for her it would be "hey firstname, chart's over there"

I guess this really doesn't address whether or not they can be friends, but perhaps illustrates more how trying to be friends when you're the "boss" can be a tricky situation.

I don't see why they can't be friends. They can be friends in ER and Nurse Jackie so obviously it happens in real life. All kidding aside I really think friendship is possible. I am a girl AND friends with three nurses who work in the hospital I practice. I always use the same language I would with any other doctors and embrace whatever opinion they may have. I've noticed that nurses help me catch any stupid mistake I make like ordering 200 mgs of whatever when it should have been 20. Hierarchy is not an issue if you work together instead of above them. There's no advantage to acting like you're better or because rules say so. I listen to the med student because he can make a smart observation I hadn’t thought about even if it turns out it’s stupid so why is a nurse (who has more experience) to be ignored? In fact, they are usually more prompt with any orders I script and overall mood is better. Be friendly!

I'm currently a nurse applying to med school and I work in a big teaching hospital with many interns and residents. I'm a couple of years younger than most of the interns and I actually find it easier to have friendly relationships with the female doctors than the males. Perhaps I'm hypersensitive to the idea of flirtatious nurses, but I'm hesitant to be too friendly or casual with the male residents lest it seem like flirtation.

All of this, of course, is under the umbrella of friendly work relationships. I don't see myself developing meaningful friendships with any of the interns/residents while I am a nurse. I agree with Fizzy - it feels like there is a huge invisible wall. I'm ambivalent about it, though. I see why it's important to maintain a healthy distance, and at the same time suspect that had we med outside the context of the workplace (like in undergrad) we could have been great friends.

Some women doctors have the same qualifications and experience that some male doctors and have gone to the well-known medical schools and has worked with top rated hospitals. And also, there are some patients who feel more comfortable going to a doctor with male doctor.

I am an ER doctor. During my residency, residents, attendings, nurses, security guards, etc hung out outside of the workplace all of the time. We were friends...played softball together, had drinks together, confided in each other, etc. Even now as an attending out of state, I am good friends with the nurses I work with. They've been to my home and vice versa. We have parties and everything together. Of course, I think people who work in the ER tend to be more free-spirited than your "typical" doctor, at least where I've worked. But, I do have an OB friend who hangs out with her nurses alot, too. So, it really just depends on the people. But, I do think they can be friends. Heck, my husband is a nurse, if that means anything.

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